Infection-related complications in patients with end stage renal failure dialyzed through a permanent catheter

Abstract

Introduction: Progression of renal failure leads to an increase in the number of patients who require forming dialysis access. Old age and rising morbidity make it impossible to form a native arteriovenous fistula and a permanent catheter becomes the first choice. The presence of a catheter frequently generates complications, including infections, which may result in a higher mortality rate. Material and methods: A retrospective analysis data has been conducted, involving 398 patients who had permanent catheters implanted from 2010 to 2016. Out of this group, 65 patients who suffered infectionrelated complications have been identified. Risk factors for infection and a survival rate of the population have been estimated. Results: Between 2010 and 2016, 495 catheters were implanted for 398 patients aged 68.73 (13.26) years on average. 92 catheter-related infections (23.1%) were recorded in 65 patients. Multivariate logistic regression showed, that the risk factors of infectious complications were: younger age (P = 0.000), coronary artery disease (P = 0.006) and heart failure (P = 0.000). Mortality in the mean 1.38 ± 1.17 years followup period was comparable in infectious and non-infectious subgroups (53.85% vs 49.25%; P = 0.588). A higher risk of death in the infectious population was associated with the presence of additional intravascular and intracardiac implanted materials (P = 0.027) and a severe course of infection with hypotension (P = 0.027), thrombocytopenia (P = 0.029) and a high leucocytes/platelets ratio (0.017). Conclusion: Infectious complications in patients dialyzed with permanent catheters are dangerous especially in patients with severe clinical course. The mortality rate is high, although similar to all dialyzed by permanent catheters.